Yes, You Can Get Pregnant While Breastfeeding

If you’re breastfeeding you probably already know supplying breastmilk to your baby comes with tons of health benefits. For instance, breastfeeding can help your baby develop a strong immune system and lower their risk of SIDS.

It also can have benefits for you, like helping reduce your blood pressure, lowering your risk of developing Type 2 diabetes, and even reducing your risk of breast cancer and ovarian cancer.

Some people will tell you that breastfeeding will also keep you from getting pregnant. Others will tell you that’s not really the case. And you’re wondering, What’s the truth? Can you get pregnant when breastfeeding?

The reality: Breastfeeding lowers your chances of conceiving, but you can still get pregnant while breastfeeding.

Ob/Gyn Emily Freeman, DO, explains the relationship between nursing and getting pregnant.

Why you can get pregnant while breastfeeding

When you’re breastfeeding, you may not get your period for a while. (Go ahead and add that to the list of benefits, if you’d like!)

That’s called lactation amenorrhea.

Here’s why it happens: When you’re breastfeeding, your body produces a hormone called prolactin. High levels of prolactin affect ovulation (when your ovary releases an egg). That can keep you from having a period.

That’s why you may hear people say that you can’t get pregnant when you’re breastfeeding. Because, they say, if you don’t have a period, you’re not ovulating. And if you’re not ovulating, you can’t get pregnant.

But they’re missing an important nugget of truth about how fertility works.

Namely, that ovulation (your most fertile days of the month) happens several days before you get your period.

“If you have unprotected vaginal intercourse while you’re ovulating, you can get pregnant. And because you ovulate before you bleed, you can get pregnant before you even get your first postpartum period,” Dr. Freeman confirms.

And even after your period returns, it may not come like clockwork (even if you had a fairly regular cycle pre-pregnancy). Your body can take time to reach a normal rhythm after having a baby. Particularly when you’re breastfeeding.

If your periods are irregular, it can be tough (if not impossible) to estimate when you’re ovulating. (And in case you’re wondering, those ovulation strips you may have relied on previously aren’t so accurate when you’re breastfeeding.)

Ovulation and breastfeeding

In the early days of breastfeeding, you’re not likely to ovulate. Especially if you’re exclusively breastfeeding and feeding your baby regularly, day and night.

But eventually, you will. And you’ll become more likely to ovulate if you:

• Pump milk.
• Supplement with formula (or outright switch to formula).
• Begin introducing solid foods.

Lactation amenorrhea method

The lactation amenorrhea method suggests that women who are breastfeeding are safe from becoming pregnant if they:

• Haven’t had a period postpartum.
• Breastfeed at least every four hours during the day and every six hours at night.
• Are fewer than six months postpartum.

When followed very strictly, the lactation amenorrhea method can work for some women. But it’s far from foolproof. And if you aren’t open to the idea of becoming pregnant again or if you have a medical condition that makes pregnancy risky, there are more reliable birth control methods while breastfeeding.

Safe birth control while breastfeeding

If having another baby right away isn’t your goal, Dr. Freeman suggests discussing contraception with your healthcare provider even before you give birth. They can help you understand your options.

She shares birth control you can use while breastfeeding.

Hormonal birth control

Hormonal birth control methods typically include the hormone progestin or a combination of estrogen and progestin.

When you’re breastfeeding, birth control methods that don’t include estrogen are preferred, especially at first. That’s because estrogen has been linked to lowered milk supply.

There are several options for progestin-only birth control that can be started immediately after delivery — even before you leave the hospital. They include:

• Hormonal intrauterine devices (IUDs), including brands like Mirena®.
• Implanted birth control device (Nexplanon®).
• Depo-Provera® shots.
• Progestin-only birth control pills, often called the “minipill.”
• Some providers will prescribe an estrogen and progestin combination pill or device (like the patch or vaginal ring) after your milk supply has been well established, if that works better for you.

When it comes to choosing a hormonal birth control method after delivery, Dr. Freeman says long-acting reversible contraception options are good choices for most people.

“Hormonal IUDs and implants are some of the most effective forms of birth control — whether you’re breastfeeding or not,” she explains. “They’re ‘set it and forget it’ approaches. You don’t have to think about taking a pill every day or scheduling an appointment for a shot. And they can last several years.”

Depending on the brand, hormonal IUDs are approved to be used anywhere from three to eight years. And if you do choose to grow your family before your IUD or implant is ready to be removed, you can get it taken out sooner.

Nonhormonal methods of contraception

Some women prefer to avoid hormonal contraception. Or they may have a health condition that makes it risky to use a hormonal birth control option.

Nonhormonal birth control can still be safe and effective for birth control options while breastfeeding. That includes options like:

• The copper IUD (ParaGard®).
• Condoms (with or without spermicides). Remember, too, that condoms are also the only reliable way to prevent sexually transmitted infections (STIs).
• Barrier methods, such as a diaphragm or cervical cap with spermicides.

If you plan to use a device you were fitted for prior to delivery, check with your healthcare provider first. You may need to get refitted after giving birth.

Tubal ligation

If you know you don’t want to get pregnant again, you may consider talking with a healthcare provider about tubal ligation (also referred to as “getting your tubes tied”). It’s a surgical, permanent form of birth control. And it’s typically considered safe if you're breastfeeding.

During the procedure, your fallopian tubes are cut, blocked off or sealed off to prevent eggs from being fertilized by sperm.

The bottom line

When you give birth, planning your next pregnancy may be the last thing on your mind. But it’s important to consider. Because no matter what you’ve heard, breastfeeding is not the most reliable birth control. Talk with your healthcare healthcare provider about your options.